Amended in Assembly March 26, 2015

California Legislature—2015–16 Regular Session

Assembly Bill No. 1254

Introduced by Assembly Member Grove

February 27, 2015

An act to begin delete amend Section 1341 of end delete begin insert add Section 1367.255 to end insert the Health and Safety Code, relating to health care service plans.

LEGISLATIVE COUNSEL’S DIGEST

AB 1254, as amended, Grove. Health care service plans: begin delete Department of Managed Health Care. end delete begin insert abortion coverage. end insert

begin insert

Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), enacts various health care coverage market reforms that took effect January 1, 2014. Among other things, PPACA requires a health insurance issuer offering coverage in the individual or small group market to ensure that the coverage includes the essential health benefits package, as defined. PPACA does not require that a qualified health plan provide coverage for abortion, as specified.

end insert begin insert

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the regulation of health care service plans by the Department of Managed Health Care. Under existing law, the Director of Managed Health Care may, after appropriate notice and opportunity for a hearing, by order suspend or revoke a license issued under the act, or assess administrative penalties if the director determines that the licensee has committed an act or omission constituting grounds for disciplinary action.

end insert begin insert

This bill would provide that a health care service plan is not required to include abortion as a covered benefit. The bill would prohibit the director from denying a license, or disciplining a licensee, on the basis that the plan excludes coverage for abortions.

end insert begin delete

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law specifies that the Department of Managed Health Care has charge of the execution of state laws relating to health care service plans to ensure that health care service plans provide enrollees with access to quality health care services.

end delete begin delete

This bill would make a technical, nonsubstantive change to these provisions.

end delete

Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

The people of the State of California do enact as follows:

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 1367.255 is added to the end insert begin insert Welfare and
Institutions Code end insert begin insert , end insert immediately following Section 1367.25 begin insert , to read: end insert

begin insert

begin insert 1367.255. end insert   

(a) Notwithstanding any other law, a health care
service plan is not required to include abortion as a covered
benefit. The director shall not deny, suspend, or revoke the license
of, or otherwise sanction or discriminate against, a licensee on
the basis that the licensee excludes coverage for abortions pursuant
to this section.

(b) This section does not require a health care service plan to
exclude or restrict coverage for abortions.

end insert

begin delete

SECTION 1.  

Section 1341 of the Health and Safety Code is
amended to read:

1341.  

(a)  There is in state government, in the California Health
and Human Services Agency, a Department of Managed Health
Care that is in charge of the execution of the laws of this state
relating to health care service plans and the health care service
plan business including, but not limited to, those laws directing
the department to ensure that health care service plans provide
enrollees with access to quality health care services and protect
and promote the interests of enrollees.

(b)  The chief officer of the Department of Managed Health
Care is the Director of the Department of Managed Health Care.
The director shall be appointed by the Governor and shall hold
office at the pleasure of the Governor. The director shall receive
an annual salary as fixed in the Government Code. Within 15 days
from the time of the director’s appointment, the director shall take
and subscribe to the constitutional oath of office and file it in the
office of the Secretary of State.

(c)  The director shall be responsible for the performance of all
duties, the exercise of all powers and jurisdiction, and the
assumption and discharge of all responsibilities vested by law in
the department. The director has and may exercise all powers
necessary or convenient for the administration and enforcement
of, among other laws, the laws described in subdivision (a).

end delete